背景:银屑病和白癜风都是自身免疫性皮肤病。以前的观察研究表明这两种情况之间存在关系,两种疾病同时发作会增加患者的健康风险。然而,有限的研究探讨了银屑病和白癜风之间的因果关系。
目的:探讨银屑病与白癜风之间是否存在因果关系。
方法:报道1例诊断为银屑病和白癜风的中国患者。转录组测序是在正常,牛皮癣,白癜风,以及患者的共同皮肤组织,并对共病皮肤组织进行单细胞转录组测序。对IEUOpenGWAS项目的261018名欧洲牛皮癣患者和国立卫生研究院(NIH)基因型和表型数据库的白癜风患者进行了全基因组关联研究(GWAS)的孟德尔随机综合分析。
结果:病例报告和转录组结果显示,白癜风合并银屑病的皮肤组织表现为白癜风和银屑病。单细胞转录组测序结果显示,与正常皮肤和银屑病皮肤相比,CD8+T细胞的比例,自然杀伤细胞,幼稚T细胞,辅助性T细胞17,调节性T细胞,常规1型树突状细胞,常规2型树突状细胞,白癜风合并银屑病皮肤组织中浆细胞样树突状细胞均增多。孟德尔随机化分析包括4510例银屑病患者和4680例白癜风患者。结果显示白癜风和牛皮癣在向前方向上没有因果关系(p=0.192;比值比[OR],1.059;95%置信区间[CI],0.971-1.155)或反向(p=0.459;或,0.927;95%CI,0.757-1.134)。
结论:本研究提示银屑病与白癜风的关系可能与免疫密切相关,然而,孟德尔随机化研究不支持因果关系。这些发现对旨在提高对牛皮癣和白癜风的理解和治疗方法的临床医生具有重要意义。
BACKGROUND: Both psoriasis and vitiligo are autoimmune skin diseases. Previous observational studies have indicated a relationship between the two conditions, and simultaneous onset of both diseases poses increased health risks to patients. However, limited research has explored the causal relationship between psoriasis and vitiligo.
OBJECTIVE: To investigate whether a causal association exists between psoriasis and vitiligo.
METHODS: A case of Chinese patients diagnosed with psoriasis and vitiligo has been reported. Transcriptome sequencing was performed on normal, psoriasis, vitiligo, and co-morbid skin tissues of the patients, and single-cell transcriptome sequencing was conducted on the co-morbid skin tissues. A comprehensive Mendelian randomization analysis of Genome-wide association studies (GWAS) was performed on a cohort of 261 018 European individuals with psoriasis from the IEU Open GWAS Project and vitiligo from the National Institutes of Health (NIH) Database of Genotypes and Phenotypes.
RESULTS: Case report and transcriptome results showed that skin tissue with vitiligo combined with psoriasis exhibited both vitiligo and psoriasis. Single-cell transcriptome sequencing results showed that in comparison to normal skin and psoriatic skin, the proportions of CD8+ T cells, natural killer cells, naive T cells, T helper cells 17, regulatory T cells, conventional type 1 dendritic cells, Conventional type 2 dendritic cells, and plasmacytoid dendritic cells were all increased in skin tissue with vitiligo combined with psoriasis. Mendelian randomization analysis included 4510 patients with psoriasis and 4680 patients with vitiligo. The results showed no causal relationship between vitiligo and psoriasis in the forward direction (p = 0.192; odds ratio [OR], 1.059; 95% confidence interval [CI], 0.971-1.155) or in the reverse direction (p = 0.459; OR, 0.927; 95% CI, 0.757-1.134).
CONCLUSIONS: This study suggests that the association between psoriasis and vitiligo may be closely related to immunity, however, Mendelian randomization studies do not support a causal relationship. These findings hold significant implications for clinicians aiming to enhance their understanding and treatment approaches for psoriasis and vitiligo.